POCUS-Assisted Therapeutic Thoracentesis

Therapeutic thoracentesis is an invasive procedure performed to relieve symptoms in patients with large pleural effusions identified on diagnostic imaging. Untreated effusions can lead to respiratory compromise or hemodynamic instability. Factors such as poor patient compliance, worsening disease progression, or limited outpatient follow-up availability may increase the need for therapeutic thoracentesis in the emergency department (ED). This article provides a comprehensive overview of the procedure with point-of-care ultrasound (POCUS) guidance and discusses indications, contraindications, and post-procedure care in the ED setting. Competence in thoracentesis and POCUS enables the emergency nurse practitioner to optimize procedural utilization and deliver safe, high-quality care for patients with significant pleural effusions.